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WHEN HANDLED POORLY, the process of health information exchange can mimic the classic childhood game "Telephone." Even though the person who kicks off the game whispers a message as clearly as they can to the person next to them, by the time the message has been passed around the circle, the final recipient of the message often has heard something completely different. The game can become an object lesson for showing how gossip gets started and misinformation is shared. Without a layer of quality assurance, each link in the chain is an opportunity to muddle the truth.
This same thing could happen when a hospital is asked to share a patient's record with a provider in the same system, or with another entity entirely, through an established health information exchange (HIE). Without strict data integrity measures in place or even a standardized method to improve patient identity matching, health data is vulnerable to corruption whenever it changes hands.
The "meaningful use" Electronic Health Record (EHR) Incentive Program succeeded in getting providers to switch from paper records to electronic ones, but it did very little to improve how those electronic records are shared. The Office of the National Coordinator for Health IT (ONC) has revamped "meaningful use" and given it a new name-the "Promoting Interoperability" program-which reflects the federal agency's focus on improving health data exchange. The rise of accountable care organizations and planned crackdown on the practice of "information blocking" by the federal government has also increased the potential for health records to be exchanged.
The ongoing increase in health information exchange has raised questions about how health information integrity is preserved and ensured when exchanging records within a healthcare organization as well as between organizations (and with patients). This responsibility often falls on health information management (HIM) professionals, charged with balancing patients' right to privacy with the need for access for legitimate uses.
As more health information exchanges (HIE as a noun) gain provider members, and providers start exchanging more health information amongst themselves (HIE as a verb), HIM professionals can use their information governance (IG), data governance, and HIPAA expertise to implement best practices in data exchange. In addition to looking at healthcare organization exchange, this article will examine how formal HIE organizations...